“The Affordable Care Act is too costly to finance, too difficult to administer, too burdensome on doctors, and too disruptive of healthcare arrangements that Americans prefer,” he writes. Repeal of Obamacare isn’t happening anytime soon. So it’s important to present the case for an alternative — “the kind of patient-centered healthcare system only a market-based model can deliver.”

Miller lists five key elements of reform.

Tax subsidies are too high, “rewarding volume instead of value and quality,” he says. “By converting our public financing from a ‘defined benefit’ to a ‘defined contribution’ model, we can control costs, trim waste, and put patients first.”

We should have a consumer-based health system rather than a government-based system. “This involves opening doors to market-driven choices, not restricting access to only politically-favored types of coverage,” he says.

Medicare and Medicaid must be reformed. “The health of our healthcare system depends on ending their trillions of dollars in unfunded liabilities, quality-blind care, arbitrary price-fixing, intergenerational inequity, and broken promises.”